Curry Community Health (CCH) CEO Ken Dukek presented the Curry County Board of Commissioners (BOC) with three options Wednesday aimed at stemming the monetary losses CCH says it is suffering in its Public Health division.
The county contracts with CCH to provide public health services.
According to the Oregon Coalition of Local Health Officials, public health services include epidemiology and control of preventable diseases and disorders; parent and child health services, including family planning clinics; collection and reporting of health statistics; health information and referral services and environmental health services.
Dukek’s presentation noted CCH contracts to serve as the county’s public health provider, except where the state requires the county to staff a person or have an office for certain services such as vital statistics registrar or to collect fines and fees for environmental health.
According to CCH, when the county was forced by the state to administer the EH fines and fees and keep them, CCH lost $75,000 in revenue.
CCH said public health is underfunded by the state and required changes have had an administrative and financial impact on CCH.
“It is becoming increasingly difficult to continue our focus on service, Dukek said. “We are administratively overwhelmed and CCH does not receive funding for the actual cost of administering the program as a subcontractor.”
Documents cited losses of $358,000 in fiscal year (FY) 2016-17, $383,000 in FY 2017-18 and a budgeted loss of about $200,000 in the current fiscal year, with a total three-year loss of more than $941,000.
Losses were taking money from the agency that could be used to create and staff a planned 12-bed, residential treatment facility for substance abuse disorders, Dukek noted, adding both the County Health Assessment and the County Health Improvement Plan cited a need for a local, residential substance abuse treatment facility.
Public health in Oregon has been underfunded for years, according to Dukek, and this is why the county wanted to place public health in the hands of a nonprofit.
He said prior to 2012 when the county provided the same services, it was having to pay between $180,000 and $200,000 per year as well as up to $500,000 for behavioral health services, and this was in addition to state funds supporting some of those services.
Dukek said the money amounts to a nearly $1 million contribution to public health made by CCH over the last three years, money taken from the agency’s primary care income. “CCH cannot continue” to do so, he said. CCH’s primary care services are not contracted by the county.
“CCH is not interested in contracting to provide a service at a $1 million loss every three years,” Dukek said.
Dukek and the CCH board proposed three options to the BOC to address the losses:
CCH would move all services, assets – excluding $500,000 for a two-year period – and personnel into Curry County control.
Curry County would provide financial support for public health directly to CCH. The state has indicated it might provide matching funds to help the county do so, but this money would not be available until the 2019-20 biennium.
CCH would surrender the public health programs back to the county’s control effective June 30, 2020.
A decision is needed on a proposal by Sept. 1 so that CCH and the county can move forward with any transitional actions necessary, according to Dukek.
During the presentation, CCH board Chair Ed Conyers said his board did not favor the proposal wherein the county would fold public health back under its auspices, noting that CCH had invested $4 million in assets and would be hesitant to give those assets to the county to do with as they wished. Dukek echoed those concerns.
County Commissioner Chris Paasch, who was absent during the workshop but who spoke with Dukek about the proposals later, said, “Their board (CCH) may be uncomfortable with what a future Curry County BOC may or may not do to protect the work they have done..”
In relation to option 2, Dukek said he was not asking the county to cover the entire deficit in public health funding, but it was “time to have a conversation” about the county paying “its fair share.”
According to Curry County Commissioner Court Boice, CCH is remarkably well managed and improving services, but he didn’t want to overly influence the decision to be made by the BOC because he is also on CCH’s board.
“Since I am also on CCH’s board,” Boice said, “I will have to step back and let the other two commissioners do their research and come to their own conclusions. I’ll be patient here and let things work out.”
Conyers said the CCH board leaned toward option 2, “because a three-legged stool can always stand,” and he said the state, the county and CHH could be those three legs.
He said the county would be unable to recruit professionals if it took the services back under its control and offered reduced county salaries, based on a salary survey CCH undertook to determine what salaries were necessary to recruit professionals to the area.
Conyers and Dukek said the BOC needed to decide on an option by Sept. 1 and a change would need to occur by June 2020. They suggested the two boards meet to work through the options on and ongoing basis.
Commissioner Sue Gold was unavailable to comment for this article, and Paasch had no comment on his opinion of the options or the information as presented by CCH.
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